護理之家機構特性與訪查結果關聯性之探討

Association Between Facility Characteristics and Outcome of On-Site Visit in Nursing Homes

本研究目的在探討護理之家特性（類型、權屬、規模）與訪查結果的關聯性（評等、委員建議事項）。以2003年全台參與訪查的221所護理之家為研究對象，分析53位訪查委員在訪查221所護理之家後，所給予的評等及撰寫的改善意見書面資料，參照2003年護理之家機構訪查評估表，由兩位實際參與護理之家訪查的研究者，個別閱讀每所護理之家訪查委員書面建議後，將之逐項歸入評估表的類組與細項內。兩位研究者歸類的一致性達90%。結果發現，訪查委員所撰寫的建議事項總計有3845項，其分佈以機構與人員管理此類組最多，佔7.8%，其次依序為安全與環境設置24.1%，健康照護19.9%，餐飲與營養16.9%，及生活照顧11.3%。以卡方統計檢定不同特性護理之家的訪查結果，發現醫院附屬型、隸屬公立與財團法人、及規模大於100床的護理之家，其評等以優等與甲等居多；除了機構與人員的管理外，規模大於100床或隸屬公立、財團法人的護理之家，有待改善的是健康照護項目；床位在50床以下及私立的護理之家則需改善其安全與環境設置。研究結果可供護理之家機構經營者與政府單位參酌。

The purpose of this study is to examine the association between the facility characteristics ( types ownership sizes ) and the outcomes of on-site visit in nursing homes ( ranks suggestions of commissioners). A total of 221 nursing homes receiving on-site visit were recruited. The suggestions of 53 commissioners were analyzed. Two researchers who participated in the 2003 nursing home on-site visit read the suggestions separately, and then divided them into the categories of nursing home on-site visit assessment scale. The Inter-rater reliability was 90. Results of this study revealed that 3845 suggestions were proposed. Among those suggestions, the top one was the category of institution and staff management(27.8), the other categories were safety and environment setup(24.1), health care(19.9), diet and nutrition(16.9), and daily care 11.3 in sequence. There were significant differences between ranks, suggestions of commissioners and types, ownership, and sizes of nursing homes. The results of this study can provide meaningful information for the executives of nursing homes and government.